Health Care Systems

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There are many differences between the healthcare systems in the United Arab Emirates and Canada. While both countries provide comprehensive healthcare for its citizens, the characteristics of the said countries differ greatly mainly due to its population dynamics. In addition, in terms of development, the UAE has not reached the state that the Canadian health care sector is currently in. Keeping the population size in mind, it is no surprise that Canada’s expenditure is much larger than the United Arab Emirates.

Even though both countries are in different stages of development, one could forecast that when the UAE’s development is at par with Canada, its expenditure will be used in a significantly more efficient manner. In order to analyze this, the expenditure per capita, number of hospitals and number of certified doctors will be evaluated from an economic perspective. Before going into the economic details of how both health care systems are established, the historical development of each health care system must first be made clear.

In Canada during 1867 the responsibility of initiating, handling and maintaining any health care institution was the sole responsibility of the provincial government. The federal government, however, controlled the marine hospitals and quarantine. Funding and delivery of health care in Canada, prior to World War II was mainly private. The first provincial hospital insurance program in Canada was established in 1947 by “The father of Medicare”, Tommy Douglas.

The concept of a provincial hospital insurance program caught on to other provinces inviting them to slowly grasp the same concept in developing provincial hospital insurance programs. The major changes that occurred in the Canadian health care system were in the 1960’s and 1970’s. The Medical Care Act – otherwise known as Medicare today, was passed in 1966. Under this act, the federal government offered to reimburse and pay much of the provincial healthcare costs, the amount being one half of the costs. . This brought about a more disciplined and secure system rather than the surcharges that doctors invoiced at that time.

This caused doctors to take a stance and began over billing to compensate for the lower incomes that they were generating that caused another health act to follow in 1984 to ban extra billing (Health Canada, 2012). Over the next decade some reforms were made such as the reduction in health expenditure from the federal government to the provincial government. Today the system remains intact and allows private insurance companies to offer coverage for services that are not covered by Medicare (Health Canada, 2012) Unlike Canada, The United Arab Emirates is still a relatively new country, gaining their independence in 1971.

Although their independence was gained in 1971, the first efforts of health care are traced back to 1943 with the establishment of the first medical center in the city of Dubai. Throughout the years the rulers of each Emirate decided to enhance the quality of their healthcare system by building hospitals in different emirates and expanding their knowledge of medicine from abroad (Our History, 2012). In 1982, the UAE’s federal government comprehensively covered all residents, however, as expected with the growing costs of maintaining such a regime, the country decided to reform this act by offering full health care coverage to citizens only.

Non-citizens were responsible for covering all medical costs with the exception of child, maternity and emergency care (Regional Health Systems Observatory, 2013). By the 1990s a modern health care system fully equipped with facilities and top of the line professionals was established. This increased job opportunities for expatriates as well as nationals, which in return helped the economy prosper. Currently there are over 40 hospitals, which is a relatively large increase from the existing 7 in 1970 (Healthcare in the United Arab Emirates, 2013).

Canada’s health care system is based on health insurance that is provided by the government. The best part about Canada’s system is that coverage is provided to all its citizens and permanent residents. Irrespective of one’s medical history, standard of living or personal income, healthcare is provided to all Canadian citizens. The provincial health insurance program covers a range of health care costs, consisting of visits to doctors, hospitals, surgery, various types of medical care and services (Canadian Healthcare, 2007) there is an application process for health care coverage for those that are new to the country or province.

When a resident is approved they are provided with a health card, which grants them access to medical facilities in that province. Health coverage is granted within a maximum wait period of 3 months (Canadian Healthcare, 2007). In general, health care is very costly – this is due to medical fees, the cost of doctors, medicines/pharmaceuticals, equipment, technology and research.

The Canadian government is spending more money on health care every year. In 2009 alone, the cost of health care was an astounding $183. billion while, according to the World Health Organization; the total expenditure on health per capita was $4,404 (Population 34 million) (WHO, 2013) In 2010, Canada used an astounding 11. 3% of their GDP towards healthcare services (WHO, 2013). This leads to the question of how the Canadian provincial health insurance program is funded. As opposed to privatization, is it based on taxes and is publicly funded, each provincial or territorial public health insurance program is administered differently (Canadian Healthcare, 2007).

In 2008 the UAE implemented a new law which stated that it was mandatory for all UAE residents and expatriates to have health insurance, irrespective of whether it was provided by an employer or sponsor. UAE nationals would be covered by government health care plans. The UAE has always been generous towards its foreign expatriates, in the sense they have always had an open door policy, however this policy led to problems as time progressed. In the nineties, expatriates overcrowded the healthcare system, which was no surprise seeing as 80% of Dubai’s population consists of foreign nationals.

This prompted the sheikhs (the ruling families) to rethink their policies, which resulted in the aforementioned law in 2008 (Pallot , 2010) In comparison to Canada, the UAE utilizes its resources a lot more efficiently. This is because they facilitate collusion between private sector health care with the government sanctioned health coverage. The UAE’s current expenditure on the health coverage per capita is $1,520 USD, which is a mere 2. 8% of their total GDP in 2009 (WHO,2013).

After reviewing the state of both Canada and the UAE’s healthcare systems it is apparent that the provincial governments expenditure is rising rapidly when examining the 10 year trends in government health expenditures consumption of the total available revenue. * According to the graph above it is evident that if the current trend continues the Provincial as well as the Federal governments will be facing a major increase in what is already considered a high expenditure for health care. Based on the statistics provided Quebec is already experiencing 50% expenditure from their annual income towards their health sector.

Furthermore, based on current trends the graph highlights that the rest of the Canadian provinces are projected to follow in Quebec’s footsteps, which could lead to dire consequences for the Canadian healthcare system as a whole (Skinner & Rovere, 2011). According to the graph above, with the constant growth rate that the UAE has been attaining it is no doubt that it will soon become one of the largest in the GCC region. Much of their expenses from health care are mainly from the government’s ideas to further enhance the quality of care given to patients.

There have already been many adjustments to the budget set for the health sector. In 2009, they had spent an estimated $8. 0 billion USD with a projected increase of 24% in spending from the federal government’s budget for the year to follow. The UAE is expected to double its total costs on healthcare by 2014 (Deloitte & Touche(M. E), 2011). The main factors of this growth will be due to its rapidly increasing population as well as many other economical factors that affect every other health care system worldwide.  With an estimated population of 9. 2 million in 2020 the country is shaping up to be a very attractive region for the private health sectors to thrive heavily. This growth will mainly be attained from the increasing level of expatriates that move there in search of better job opportunities and a higher standard of living (Deloitte & Touche(M. E), 2011).  Unlike Canada, which pushed many provinces to increase tax burdens on its residents and citizens to cover some of the costs, the UAE is not forecasted to have a financial burden when it comes to their health sector.

Studies have shown that such a counter-productive increase in taxes actually causes many problems in the country’s economy in the long run. Such problems include a decrease in economic growth and a reduction in the country’s projected revenue growth. From past experience, tax increases have shown that they will temporarily adjust the annual rate for revenue but over a long period of time prove to be extremely hurtful for the economy (Skinner & Rovere, 2011). This further goes to show that their current model of health care puts a lot of burden on the provincial governments.

There has been a great array of researchers and analysts who came to similar deductions of where the country currently stands in terms of health care. Like any country that would find itself in such a position, Canadian provincial governments are currently putting in efforts to ration and even restrict current aggregate spending as a way of sustaining the increase in governmental health expenditure. As expected, making such a drastic drop in spending they faced a reduction in many of their major sectors.

Some of which include a decrease in the effective supply of health professionals, the accessibility of modern medical equipment, a restriction in the possibility of coverage for any recent medicines that are under public drug insurance coverage. All these budget cuts caused a spiral of issues for patients across the country with an increase in the wait times due to lack of health care resources. Shown below are some figures on how the average median wait times (in weeks) have amplified from 2000 to 2010. These findings have been gathered from a variety of 12 fundamental medical specialties.

Other studies have shown that wait times have almost doubled since the early 1990’s. During 1993 it was 9. 3 weeks as an average median total nationally while in 2010 it is estimated to reach 18. 2 weeks (Skinner & Rovere, 2011). One key characteristic of the UAE’s healthcare system is its diverse, multicultural base of medical staff. While some may look at this as a challenge due to issues regarding collusion between the different healthcare personnel, there are many advantages. Such advantages include the collective knowledge of the workforce that has been accrued from experience in a plethora of different cultures and backgrounds.

While the UAE may not be as advanced as other countries in terms technological development, this advantage gives them an edge due to the collaboration of knowledge (Deloitte & Touche(M. E), 2011). From an economic perspective the country seems to be on a steady economic path with an expected increase of 5. 5% annual growth rate in terms of GDP per capita, which makes it $58,000 (Deloitte & Touche(M. E), 2011). With both governmental spending and GDP on a rise it is no shock that this has in return improved consumer confidence, which would boost the private consumption in the country.

Having a proliferation of consumption as such would show a great improvement in the population’s ability to sustain increasing advanced health services. The figure below indicates that the projected growth is from $30,896 (2010) to $43,583 (2015) (Deloitte & Touche(M. E), 2011). Based on extensive research it would be safe to conclude that the direction that the UAE’s healthcare system is headed in is significantly greater than the one Canada is currently in. As a direct result of the UAE’s efforts, in a 10-year window one could forecast that their system will be in a considerably better position economically.

While Canada may have an edge when it comes to technological advancements, such an advantage is offset by the lower quality of care received and lower amount of time they are able to dedicate to a patient based on the high volumes they deal with. While many of the repercussions of the Canadian healthcare system’s decisions can be attributed to their population dynamics, when comparing the two systems it would appear that the UAE is making its decisions after evaluating them carefully which would lead to better results.

Canada provides healthcare for all of its permanent residents, while the UAE realized at an early stage that the scope was getting too large, and adjusted their system so that healthcare was still mandatory, however the government would only provide full benefits for its citizens. While one could argue that by coming to this realization during the early stages of their healthcare’s establishment the government had avoided many of the spending burdens that are being faced by Canada today.

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